Compulsory medical examinations (CMEs) are conducted by doctors at the request of insurance companies in personal injury cases. They were once known as “independent medical examinations,” but insurance companies were forced to change the title because it was deemed misleading. Why? Because the important thing to understand when it comes to CMEs is that the incentives of the process do not favor the person being examined. Here’s what you should know.
Compulsory medical examinations are requested and paid for by insurance companies. While doctors, nurses, and other medical professionals are generally well-intentioned people practicing in healthcare to help others, they are also doing a job, and a job means they are getting paid. When the people paying their bills are insurance companies, it’s reasonable to assume there is room for corruption or, at least, leaning in favor of the insurance companies.
If you are filing a personal injury claim, and a doctor examines you and finds that you are either faking or exaggerating the extent of your injury, he or she may make suggestions to the insurance company that are not in your favor. These suggestions can lead to you not receiving as much money as you would have hoped or, in some cases, can mean you are put under surveillance.
CMEs can occur at two points following an auto injury—before and after filing a lawsuit.
Before filing a lawsuit, your auto insurance company may require you to submit to a compulsory medical examination, during which you are examined by a doctor that they pay. Your car insurance company might require you to submit to a CME if they suspect that you (or your treating doctors) are exaggerating your injuries—or if they think they can get away with paying your treating doctors less money.
After a lawsuit is filed, the defense has a right to compel you to see one of their doctors for each type of treatment you are seeking or receiving. For example, if you are seeing both an orthopedist and a neurologist, you may be expected to submit to both an orthopedic and a neurological CME (again, paid for by the defense to minimize the amount of money they will eventually have to pay).
Judge Meenu Sasser, a Palm Beach County Circuit Court Judge, issued a trial order that very clearly explains and limits the concept of a compulsory medical examination. The order outlines some of the issues associated with CMEs, namely having to do with the incentive problem and the problems associated with insurance companies hiring investigators to “prove” claimants are faking or exaggerating their injuries.
The persistence of insurance companies in showing that certain claimants are lying often crosses many boundaries. There are instances in which you or someone you know may be genuinely injured yet may continue to perform tasks that are painful and or potentially detrimental to your health. This does not necessarily mean that someone injured is faking or exaggerating their injuries—they may simply be “grinning and bearing” it. There are other instances in which insurance companies effectively make absurd demands that require people to risk their livelihoods and incomes to “prove” that they are genuinely injured.
This is why it is so important to have an experienced personal injury attorney on your side to deal with insurance companies and make sure that you present yourself and your injury in the right light while, at the same time, not risking your financial security. An experienced attorney can help prove your injury to an insurance company if they doubt your credibility or the seriousness of your injury. Experienced personal injury attorneys will also coach you on how to act and what to say during your compulsory medical examination because it is critical that you know what to do.
Before an investigation, you should take your time to review your medical history and prepare for any doctor questions related to your injury. These questions can relate to the amount of pain you are experiencing as well as other things like how your injury or accident has impacted your life. While honesty is always the best policy, there are certain things that you should and shouldn’t say, even when you are telling the truth. Understand that while the doctor examining you may be well-intended, he or she is still being compensated by the insurance companies and, thus, the incentives are not in your favor. You must always be careful about how you present yourself and your injuries.
If you or someone you know has been injured and has made an insurance claim, you need experienced personal injury attorneys on your side to review your situation and ensure that you are taking the right steps to get the financial compensation and help that you deserve. Reach out to Neufeld Law Firm today to learn more about how we can help.
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